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中国癌症防治杂志

中国癌症防治杂志 ›› 2016, Vol. 8 ›› Issue (4): 225-229.doi: 10.3969/j.issn.1674-5671.2016.04.06

• 临床研究 • 上一篇    下一篇

肝细胞癌根治性切除术后AFP半衰期与复发的相关性研究

  

  1. 广西医科大学附属肿瘤医院肝胆外科
  • 出版日期:2016-08-25 发布日期:2016-09-12
  • 通讯作者: 刘剑勇 ljyljy99@aliyun.com
  • 基金资助:

    广西科学研究与技术开发计划攻关项目（桂科攻1355005-3-3）

Post-resection screening of recurrence in patients with hepatocellular carcinoma based on alpha-fetoprotein half-life

  • Online:2016-08-25 Published:2016-09-12

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摘要：

目的 探讨BCLC-A期肝细胞癌（hepatocellular  carcinoma，HCC）患者根治性切除术后甲胎蛋白（alpha fetoprotein，AFP）半衰期与HCC复发的关系。方法 对2007年1月至2012年12月行根治性切除术的309例BCLC-A期HCC患者的临床资料进行回顾性分析，将患者分为AFP（+）组和AFP（-）组，比较两组患者术后无瘤生存时间，并对AFP（+）患者术后不同AFP 半衰期组间无瘤生存时间进行分析。结果 AFP（+）组与AFP（-）组的中位无瘤生存时间分别为54.3个月、64.3个月，两者比较差异有统计学意义（P=0.041）。AFP（+）组患者术后AFP半衰期≤5 d和>5 d的中位无瘤生存时间分别为59.1个月、46.2个月，两者比较差异亦有统计学意义（P=0.048）。结论 HCC根治性切除术后AFP（＋）者的预后较AFP（-）者差，术后AFP半衰期≤5 d和>5 d可作为HCC的根治性切除术后复发的预测指标。

关键词: 肝肿瘤, 根治性切除术, AFP, 半衰期, 复发, 生存时间

Abstract:

 Objective To investigate the value of determining the half-life of alpha-fetoprotein（AFP） to screen for recurrence in patients treated by resection for hepatocellular carcinoma （HCC） in BCLC-A stage. Methods Medical records were retrospectively analyzed for 309 patients who underwent curative liver resection at our hospital from January 2007 to December 2012. Patients were assigned to an AFP-positive or-negative group based on AFP assay，and the two groups were compared in terms of tumor-free survival. Subgroup analysis was performed for patients showing different AFP half-lives. Results Median tumor-free survival time was 54.3 months in the AFP-positive group and 64.3 months in the AFP-negative group. Among AFP-positive patients， median tumor-free survival of those with an AFP half-life ≤5 days was 59.1 months， compared to 46.2 months for those with an AFP half-life >5 days （P=0.048）. Conclusions Prognosis after curative liver resection is worse for AFP-positive patients with HCC than for AFP-negative patients. Stratifying patients based on AFP half-life （≤5 or >5 days） may help predict prognosis in such patients.

Key words: Liver neoplasm, Hepatectomy, Alpha-fetoprotein, Half-life, Recurrence, Survival time